One of the most common reactions I get to my advice to try intermittent fasting is:  I could never do that!

Like the Jackson Browne song “Running on Empty,” the word “fasting” often conjures up dire images of starvation and energy deprivation.  Many of you reading this post may have experienced strong hunger pangs, headaches, tiredness, sweating and even shaking or wooziness when going without eating for even part of a day, much less a whole day.  So it is natural to extrapolate such experiences into the thought that going without food for a day, or even several hours, would invariably lead to uncomfortable or even dangerous hypoglycermic symptoms. That, together with the negative image of fasting as something unhealthy or associated with eating disorders, leaves most people pale at the thought of even attempting a short fast.

But I tell you, if you don’t try fasting you are missing out on an enjoyable, incredibly energizing experience that will put you in control of your eating and improve your health, your energy and your outlook.  Many people, myself included, have learned to fast for up to a day or even longer, on a regular basis and without negative repurcussions. Done correctly, short-term fasting is not dangerous, it’s actually health-promoting and greatly helps to retrain your appetite.  If you need to lose weight, the fast helps both in reducing basal insulin and retraining your appetite to be smaller. I’ve written about the benefits of intermittent fasting extensively on this site. Many of the Diet Links listed in the right-hand panel, such as fast-5 and Eat-Stop-Eat, amply document the safety and health benefits of fasting, dispelling the myths about “starvation mode”, slowing of metabolism,  and loss of lean muscle mass.  So I won’t reiterate here the voluminous evidence supporting the benefits of intermittent fasting.  Our bodies are designed to last many days with out food, without great discomfort, and in fact it is beneficial to our health to forgo food periodically. But many of you are asking: Am I really up to this?  How do I get started?

To clarify, by intermittent fasting (IF), I mean forgoing eating for at least 12-20 hours in a day, at least one or two days each week. For many of us, it is a daily practice. Water and unsweetened, non-caloric beverages are allowed, but I exclude “juice fasting” or any solid snacks from true fasting. Others have written about the virtues of juice fasts for “detox” or “cleansing”, but IF has a different purpose, namely insulin reduction, appetite reduction, and mental clarity and focus.

Tips for getting started. So this post is not about the benefits of intermittent fasting, but rather about how to get started with it.  I’m basing this largely on my own personal experience, combined with what I’ve learned about what has worked for others. Fasting is not that hard or unpleasant to do. The reality is that, like skydiving, the contemplation of it is probably far worse than the experience.  You will experience some periods of discomfort, but you may be surprised at how great you’ll feel most of the time you are fasting, especially once you are past the first few hours.  People on low carbohydrate diets often (but not always) experience the pleasurable energy that comes with ketosis; I’ve found that the ketosis of fasting is deeper, and more reliable that that from low carb.  Several people who experience brain fog on low carb  find fasting to provide greater clarity and energy.

Here are 7 practical suggestions to help you get through the transition:

1. Start with a mini-fast. How long do you go between meals without eating? Two hours? Five hours? Start there and try to increase it by a few hours. The easiest way to start is to cut out eating anything between dinner and bedtime. Then go to cutting out afternoon snacks 2 or 3 days a week. And increase from there in increments. Of all my suggestions, I think this is the most important. It’s one of the core principles of using Hormetism to improve your strength and resilience in any challenging endeavor. You have to walk before you can run.

A very common mistake that many people make when embarking on fasting is to go straightaway from a typical pattern of 3 meals per day with snacks, to a day-long fast.  That’s a terrible idea, and yet it forms the main reason that so many people reject fasting as impractical or unhealthful.  I’ll repeat here the comments I made in an earlier post on Calorie restriction and hormesis about a researcher’s conclusions in a 2006 study of calorie restriction in mice, in the journal Biogerontology:

Calorie restriction is doomed to fail, and will make people miserable in the process of attempting it,” said Dr. Jay Phelan, an evolutionary biologist at the University of California, Los Angeles, and a co-author of the paper. “We do see benefits, but not an increase in life span.” Mice who must scratch for food for a couple of years would be analogous, in terms of natural selection, to humans who must survive 20-year famines, Dr. Phelan said. But nature seldom demands that humans endure such conditions. Besides, he added, there is virtually no chance Americans will adopt such a severe menu plan in great numbers. “Have you ever tried to go without food for a day?” Dr. Phelan asked. “I did it once, because I was curious about what the mice in my lab experienced, and I couldn’t even function at the end of the day.

It’s not surprising that Dr. Phelan’s personal “one day experiment” failed and that he “couldn’t function” after suddenly downshifting gears so rapidly. As anyone who has taken the time to research calorie reduction or intermittent fasting realizes, a dietary change of this sort should be approached gradually, allowing time for deconditioning of previous dietary habits and hormonal responses. These changes typically take weeks or longer to become comfortable. But that does not mean that a reduced calorie diet is “extreme”. By historical standards, it would be more accurate to characterize the typical hypercaloric American diet as extreme.

2.  Schedule your fasts. Intermittent fasting works best when you are in control of the timing.  I like being able to spontaneously decide when I’ll start my next fast and I plan exactly when I’ll break the fast and eat.  That really frees me from thinking about food and making choices, because I know that at 4 p.m. Friday or noon Sunday I’ll have my next meal. Associating the start and stop of a planned fast with definite events or times of day takes advantage of the well-known behavioral principle of “putting on cue”.  For a fuller explanation, check out the work of Karen Pryor, the renowned animal behaviorist and dolphin trainer.  I’ve also written about this on the Psychology page of this blog.

3. Cheat using high fat “training snacks”. If you’re having trouble fasting, it is likely that you are lacking the ability to readily shift to fat burning and ketosis.  When you are fasting, after initially depleting your glycogen stores, you will be literally “living off your fat”, as well as fat byproducts like ketones.  To do that, you’ll need to get your insulin level very low and upregulate your catabolic hormones and enzymes: glucagon, adrenaline and hormone sensitive lipase.  But if you are used to eating 3 or more meals and snacking frequently, then you are not used to metabolizing your own fat stores, and you have difficulty shifting quickly from energy storage (anabolism) to energy release (catabolism) .  You literally have weeks of “meals” stored beneath your skin and within your abdomen.  You just can’t access them.  It’s literally like having a locked pantry on your body, so when you get hungry you have to eat food supplied externally, instead of what is already within you.

So train yourself to burn fat by eating pure fat or oil!  The easiest way to train your body to get it used to burning fat, is to “jump start” it with a small high-fat “training snack”.   You don’t need much to get started: 5 to 10 grams of fat is plenty.  Don’t worry, this is not a “high fat diet”, it serves only to provide some satiety and let your metabolism get used to fat burning. The amount of fat you’ll snack on is trivial compared to your overall weekly diet, and you’ll go back to your “normal” diet after the fast. The best approach is to wait until you would normally have a meal or snack and substitute the high fat training snack.  This will tend to suppress your appetite for at least a few hours.  If you start to get hungry again, take another training snack — but wait at least 3-4 hours between these snacks. The training snacks must be virtually free of any carbohydrates or protein and must be small.  Good examples include:

• “Carbless cream soda”. Pour a few tablespoons of heavy whipping cream into a glass (check to make sure it has less than 1 gram carbs) over ice cubes and add sparkling water or herbal tea.
• “Platinum” tea or coffee. To an unsweetened cup of hot tea or coffee, add a tablespoon or two of heavy whipping cream or coconut oil.  The heavy cream has the advantage of easily blending with the tea or coffee, but some people find the coconut oil to be more energizing.  It comes as a solid but readily melts in the hot beverage; it tends leave some oily droplets on the surface because it does not emulsify as well as cream, but most people have no problem with that.  It is important not to add any sweeteners; even artificial sweeteners will tend to psychologically induce a conditioned preprandial insulin response (See Diet page).
• Macademia nuts.  These are high in fat with very few carbs.  Eat no more than a half dozen.
• A small piece of cheese. This is a great training snack, but keep it to one or two small slices of cheese.
• A tablespoon of oil. It may not sound very palatable, but a spoonful or two of extra light olive oil or other vegetable oil can be a great appetite suppressant and kick you into fat burning mode rather effortlessly. The oil works best if flavorless, or if you pinch your nose to avoid tasting it before rinsing.  This is the basis for the popular Shangri-La Diet of Seth Roberts. Roberts attributes the effect to breaking the connection between flavor and calories.  I propose an alternative explanation in my post on Flavor Control Diets.  and also in a long discussion thread on the Shangri-la Diet forum. In any case, flavorless or not, a small dose of oil is a very effective “bridge” to fasting.

4.  Savor flavored calorie-free beverages. To satisfy your need for flavor, enjoy herb teas and black coffee.  Decaf is preferable, but if you have a caffeine habit, go with it for now.  Don’t add any sugar or artificial sweeteners, since these can induce an insulin response that shuts down fat burning. Flavored beverages are a great boon to fasting because they satisfy the urge for flavor and provide some pleasure that can be a big help.

5.  Smell something aromatic while fasting. This is an old aromatherapy trick to turn off your appetite, but it has a scientific basis.  A strong aroma from herbs, spices, flowers or perfumes can rapidly dampen a craving by saturating the cephalic phase insulin response, as explained in my post on Flavor control diets — but you must not eat within 30 minutes after smelling. It is also useful to repeat the smelling frequently and cycle between very different aromas. This has been exploited in devices such as the SlimScents odor inhaler, but a few minutes with your spice rack, perfume bottles or flower garden may do the trick.  The good news is that the effect is long lasting and will permanently decondition your cravings.  Try it!

6.  Drink water frequently. This is an old standby and may seem boring compared to the above two suggestions.  But it works well in two ways: it tends to suppress hunger, and it keeps you hydrated. Keep in mind that the effect is often delayed, so wait 15-30 minutes after drinking the water before you pass judgement on it.

7.  Exercise briefly when hungry or tired. This is one of the more surprising ways to fight cravings, tiredness, mental fog, or borderline hypoglycemia. It may seem counterintuive to expend energy just at the point you are feeling hungry or tired. But it works incredibly well! The key is to do it at the first sign of a cranky or tired feeling, and you’ll head off it off at the pass.  By “exercise” I don’t necessarily mean going to the gym — unless you are used to that. Walking around for 5-15 minutes at a brisk pace is good enough, particularly if you can elevate your heart rate a bit. If you have been fasting, walking or other brief exercise will stimulate your liver to release glucose and free fatty acids, giving you an energy boost. It really is just about as good as eating a meal, for providing energy, and it has the benefit of providing a more sustained form of energy.  You’ll find that “after lunch” meetings are less soporific.

Getting out for a lunch time walk is an excellent alternative to eating lunch.  It gets you away from the kitchen or cafeteria, changes the scene and restores energy.   I probably eat only two lunches a week at work; the other days I go walking either outside or inside, depending on the weather.  Make it social and enlist a friend or start a small walking group – it is just as easy to converse while walking as while eating at a table.

When you get more experienced with fasting, the addition of extended, more intense exercise is very energizing and beneficial. With lower basal insulin levels and upregulated catabolic hormones and enzymes, you’ll find that a long run or workout with weights provides lasting energy and suppresses your appetite. Eating before or after the fast ruins the benefits. Wait at least several hours after the workout before breaking the fast. This may seem paradoxical, as it is virtually the opposite of what many experience who are not used to fasting.  But I have found it to be my experience.  For those interested in fasted workouts, checkout Martin Berkhan’s Leangains blog, as well as a recent article in Running Times on the benefits of glycogen-depleted exercise for greatly increasing your endurance; it appears to be a great strategy for learning to burn fat and weaning yourself off carb dependence,

A final word. The above approach, which emphasizes gradualism, should give your metabolism time to adapt.  For most people, this is enough to avoid any health issues with hypoglycemia or diabetic complications.  In fact, Lee Shurie cured his diabetes, normalized his blood sugar, and increased his energy level by carefully monitoring his blood glucose and gradually transitioning to intermittent fasting.  He found that all the traditional advice to eat low glycemic foods and exercise was insufficient to normal his blood glucose. Eventually, by delaying meal time and allowing his blood glucose to drop into the normal range, he found himself eating only at dinner time, and all the happier for it.  So transition to IF gradually. However, if you have any concerns, stop the fast and eat.  Consult with your physician if you have concerns.  Otherwise, check out the discussion of Intermittent fasting on the Getting Stronger Discussion Forum, to read others’ experiences.

Happy Thanksgiving!

As one form of hydrotherapy, the health benefits of cold water therapy are numerous.  Cold showers provide a gentle form of stress that leads to thermogenesis (internal generation of body heat), turning on the body’s adaptive repair systems to strengthen immunity, enhance pain and stress tolerance, and ward off depression, overcome chronic fatigue syndrome, stop hair loss, and stimulate anti-tumor responses.

Some people advocate starting with a warm shower, and switching over to cool or cold water only at the end of the shower. This is fine, particularly if you are afraid that a pure cold shower would just be too uncomfortable or intolerable.  But I prefer just jumping right in. When you start with cold water, you will experience the phenomenon of cold shock, an involuntary response characterized by a sudden rapid breathing and increased heart rate. This in itself is very beneficial. The extent of cold shock has been shown to decrease with habituation, and exposure to colder water (10C or 50F) appears to be more effective than just cool water (15 C or 59F) in promoting habituation. The habituation itself is what is most beneficial, both objectively and subjectively. There is an analogy here with high intensity resistance exercise and interval training, both of which elevate heart rate and lead to long term adaptations to stress, with improved cardiovascular capacity and athletic performance.

But cold showers provide a different and probably complementary type of habituation to that which results from exercise. A study of winter swimmers compared them with a control group in their physiological response to being immersed in cold water:  Both groups responded to cold water by thermogenesis (internal production of body heat), but the winter swimmers did so by raising their core temperature and did not shiver until much later than the controls, whereas the control subjects responded by shivering to increase their peripheral temperatures. The winter swimmers also tolerated much larger temperature differences and conserved their energy better. Other studies confirm that the benefits of habituation show up only after several weeks of cold showering. For example, adaptation to cold leads to increased output of the beneficial “short term stress” hormones adrenaline and thyroxine, leading to mobilization of fatty acids, and substantial fat loss over a 1-2 week period.

So regular cold showers, like high intensity exercise, and intermittent fasting, appear to provide similar, but not identical hormetic benefits.

But now I’d like to focus on the subjective experience of taking cold showers, something not commented on in many of the studies I’ve read. If you follow my approach and plunge right into a cold shower, you’ll get the initial “cold shock” mentioned above:  a quickened pace of breathing and a pumping heart.  Often I find myself involuntarily smiling or even laughing.  For waking up, this beats caffeine. I keep the water cold the whole time. It helps to brace yourself when entering by gritting your teeth and stiffening your muscles. Go in head first and alternate from back to front to make sure you are getting cold all over, including your hands and arms and any sensitive zones. After about a minute, you’ll find the cold water starts to become more tolerable, and after 2 or 3 minutes you’ll feel your body getting warm by its own efforts. This is thermogenesis. I make a point of staying in the shower until I’m no longer uncomfortable.  I found that at first my hands were the most sensitive part, and now they are no longer as sensitive, so they have habituated.

When I started taking cold showers, I measured the water temperature at around 60 F (16 C), but over time I have reduced this somewhat to 50-55 F (10-13C) as my body has adapted. (You can determine this by bringing into the shower a plastic cup and meat or candy thermometer and collecting some water once the temperature equilibrates).  Of course, depending on where you live and the season, there is a lower limit to how cold you can go, but in general you should be able to get at least as cold as 60F in most places. Also, my cold showers used to be very short, maybe 4 or 5 minutes, but now they last as long as my previous warm showers, perhaps 10 minutes.  I still take the occasional warm shower, perhaps once every week or so, but I prefer the cold ones.

I find that cold showers are great for the mood.  Not only are they physically invigorating, they make you feel alive, vital and ready to take on the day. They stimulate thinking early in the morning. I also believe that they have the effect of slightly raising blood glucose very quickly — by perhaps 10 mg/dl, and thereby have an appetite suppressing effect. Generally, this rise in blood glucose is relatively short in duration, but that’s good enough to prime the pump and get the day started.  This effect of cold showers works well with my practice of skipping breakfast most days and often fasting until dinner.

These effects are apparent with the first cold shower. If you continue the practice for several weeks, you’ll find the psychological benefits are even greater. First and foremost, cold showers appear to have improved my stress tolerance, by buffering emotional reactions. What I mean by this is that bad news, surprises, arguments, or events that would have previously caused a brief surge in adrenaline or an emotional flush, no longer have that effect, or at most have a very attenuated effect.  I think this is a consequence of becoming acclimated to the the adrenaline-producing effect of the cold shock.  A deeper explanation of why cold showers are effective in boosting mood, and why the psychological benefits of cold showers increase the longer and more frequently you take them is addressed in my recent post on the opponent-process theory of emotions.

As with any application of Hormetism, you can experiment with the intensity of cold, the duration, and the frequency of cold showers to improve your tolerance at a tolerable rate.  If you find that your heart is beating uncomfortably fast or you are going numb or experiencing pain of any sort, that’s a good reason to ease into the routine more slowly with water that is not so cold. Check with your doctor first if you have a heart condition, migraines, or pain.  But don’t sell yourself short and rush through a cold shower, because you may find that extending a few more minutes provides the greatest benefits in adapting your body to tolerate stress. Not just cold stress — but physical and emotional stress in general.

January 29, 2012 update:  If you want to take cold showers to the next level, check out this recent article on The Iceman.